Comparative Efficacy of Transfusion Strategies in Women and Men With Myocardial Infarction and Anemia: Prespecified Secondary Findings From the MINT Trial.

The Myocardial Ischemia and Transfusion trial (MINT) randomized patients with AMI and anemia to restrictive or liberal transfusion thresholds, but sex-stratified outcomes remain undefined.

心肌缺血和输血试验（MINT）将AMI和贫血患者随机分为限制性或宽松的输血阈值，但性别分层的结果尚未明确。

The objective was to evaluate whether the clinical effect of restrictive versus liberal red blood cell transfusion strategies differs by sex in patients hospitalized with AMI and anemia.

本研究旨在评估在住院的急性心肌梗死和贫血患者中，限制性与宽松性红细胞输血策略的临床效果是否因性别而异。

Methods

In this prespecified secondary analysis of the MINT trial, we examined outcomes by sex and transfusion strategy.

在这项MINT试验的预先指定的次要分析中，我们按性别和输血策略检查了结果。

The primary outcome was 30-day composite death or MI.

主要结果是30天内的死亡或心肌梗死的复合终点。

Secondary outcomes included heart failure, stroke, cardiac death, and 180-day mortality.

次要结果包括心力衰竭、中风、心脏死亡和180天内的死亡率。

Adjusted relative risks (RRs) and hazard ratios (HRs) were estimated accounting for sex differences at baseline.

在基线时考虑性别差异后，估计了调整后的相对风险（RRs）和风险比（HRs）

Interactions between sex and transfusion effects were assessed.

评估了性别与输血效果之间的相互作用。

Results

There were 3504 study participants, of whom 1593 (45.4%) were women.

研究共有3504名参与者，其中1593名（45.4%）为女性。

Women received fewer transfusions on average.

平均而言，女性接受的输血次数较少。

Primary outcome occurred in 15.7% of women and 15.7% of men and occurred in 16.5% of women and 17.1% of men in the restrictive arm, versus 14.9% and 14.2% in the liberal arm, respectively.

主要结果发生在15.7%的女性和15.7%的男性中，在限制性治疗组中，分别发生在16.5%的女性和17.1%的男性中，而在宽松治疗组中，分别发生在14.9%和14.2%的男性中。

Women had a lower mortality between 30 and 180 days (11.0% versus 13.5%; P=0.04).

女性在30至180天之间的死亡率较低（11.0%对比13.5%；P=0.04）。

There were no statistically significant interactions between sex and transfusion strategy for the primary outcome (interaction P=0.60).

性别与输血策略之间对于主要结果没有统计学上显著的相互作用（相互作用P=0.60）

For 30-day cardiac death, a higher RR in men was observed in the restrictive transfusion arm (RR, 2.34; 95% CI, 1.48-3.70; interaction P=0.05).

在限制性输血组中，男性30天心脏死亡的相对风险更高（RR，2.34；95% CI，1.48-3.70；相互作用P=0.05）

Conclusions

For MINT patients with anemia and AMI, women comprised nearly half of the study population, and randomization to a restrictive or liberal transfusion strategy resulted in comparable outcomes in women and men.

在患有贫血和急性心肌梗死(MINT)的患者中，女性占研究人群的近一半，随机分配到限制性或开放性输血策略的女性和男性的结果相当。

These findings support sex-neutral transfusion thresholds.

这些发现支持性别中立的输血阈值。

registration

URL: https://www.clinicaltrials.gov; Unique identifier: NCT02981407.

网址: https://www.clinicaltrials.gov; 唯一标识符: NCT02981407.